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Medial column arthrodesis and calcaneal osteotomies are commonly used for adult-acquired flatfoot surgical reconstruction. In this case series, 10 patients (11 feet) with a mean age of 54 ± 13 years underwent a medial column arthrodesis, with or without calcaneal osteotomy, between 2010 and 2017. The indication for surgery was a painful flatfoot deformity with peritalar subluxation and a fault in the naviculocuneiform joint. At a mean of 9.9 (range 2.5 to 33.1) months after surgery, in patients who underwent a medial column arthrodesis, radiographs showed a mean decrease in the talonavicular coverage angle of 8.4° ± 8.5° (p = .013), and mean increases in the lateral talometatarsal and calcaneal inclination angle of 10.6° ± 10.3° (p = .002) and 2.2° ± 4.4° (p = .067), respectively. One nonunion (1 of 11 [9.1%]) occurred at the naviculocuneiform. These findings demonstrate marked improvement of radiographic flatfoot parameters after medial column arthrodesis., (Copyright © 2018 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)